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Chiu L, Corpus GH, Lien M, Chu JP. The Culturally Infused Curricular Framework (CICF) for Suicide Prevention Trainings. Health Promot Pract 2024:15248399241234064. [PMID: 38439682 DOI: 10.1177/15248399241234064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/06/2024]
Abstract
Although suicide prevention trainings (SPT) have been a standard approach for suicide prevention for years, researchers have noted a need for more clarity in the definition of core competencies for SPTs, particularly in the areas of diversity and culture. Recent research has identified key theoretically- and empirically-based cultural considerations for suicide prevention, but translation is needed to infuse these standards for culture-related competencies into SPTs. This study performed a systematic literature review with a thematic synthesis analytic approach to establish a set of curricular guidelines for infusion of cultural considerations into SPTs. The study also examined the extent to which existing community trainings already incorporate cultural components. Based on the thematic synthesis of 39 SPT studies from 2010 to 2020 and seminal reviews of the cultural and suicide literature, results identified three overarching categories of cultural curricular competencies (suicide knowledge and awareness, suicide intervention skills, and curriculum delivery) and 14 core cultural curricular subthemes for community trainings (e.g., culturally informed risk factors and warning signs, systemic inequities, etc.). These three categories with 14 core cultural curricular competencies comprise the Culturally Infused Curricular Framework (CICF) for Suicide Prevention Trainings. The majority of trainings (62%) included five or less out of 14 total possible core cultural competencies in their training curricula, pointing to insufficient integration of cultural components in existing community trainings. This study's research-based guideline establishes a culture-inclusive framework to strengthen content and approach of community trainings and suicide prevention across cultural groups.
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Affiliation(s)
- Lorna Chiu
- Palo Alto University, Palo Alto, CA, USA
| | | | - Mego Lien
- County of Santa Clara Behavioral Health Services, San Jose, CA, USA
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2
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Iida M, Sawada U, Usuda K, Hazumi M, Okazaki E, Ogura K, Kataoka M, Sasaki N, Ojio Y, Matsunaga A, Umemoto I, Makino M, Nakashita A, Kamikawa C, Kuroda N, Kuga H, Fujii C, Nishi D. Effects of the Mental Health Supporter Training Program on mental health-related public stigma among Japanese people: A pretest/posttest study. PCN REPORTS : PSYCHIATRY AND CLINICAL NEUROSCIENCES 2024; 3:e176. [PMID: 38868483 PMCID: PMC11114268 DOI: 10.1002/pcn5.176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 01/15/2024] [Accepted: 01/25/2024] [Indexed: 06/14/2024]
Abstract
Aim The Mental Health Supporter Training Program is a national project conducted in Japan. This study aimed to determine the effects on mental health-related stigma, mental health literacy, and knowledge about mental health difficulties and support techniques among program participants. Methods The target population was local residents of a wide range of generations in Japan. Outcomes were assessed at baseline (T1), immediately postintervention (T2), and at the 6-month follow-up (T3). A mixed model for repeated-measures conditional growth model analyses were employed to examine the effects of the intervention over time (T1, T2, T3). We also calculated effect sizes using Cohen's d. Results The program had a significantly favorable pooled effect on the Japanese version of the Reported and Intended Behaviour Scale score after adjusting for covariates (reported behavior [t = 3.20, p = 0.001]; intended behavior [t = 8.04, p < 0.001]). However, when compared at each time point, only intended behavior from T1 to T2 showed a significant difference (t = 8.37, p < 0.001). Significant pooled effects were found for mental health literacy (knowledge: t = 19.85, p < 0.001; attitude: t = 15.02, p < 0.001), knowledge of mental health (t = 28.04, p < 0.001), and psychological distress (t = -2.41, p = 0.016). Conclusion The results suggest that the program might be effective for improving intended, but not reported, behavior in the short term and for improving mental health literacy, knowledge of mental health, and psychological distress.
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Affiliation(s)
- Mako Iida
- Department of Public Mental Health Research, National Institute of Mental HealthNational Center of Neurology and PsychiatryTokyoJapan
- Department of Mental Health, Graduate School of MedicineThe University of TokyoTokyoJapan
| | - Utako Sawada
- Department of Public Mental Health Research, National Institute of Mental HealthNational Center of Neurology and PsychiatryTokyoJapan
- Department of Mental Health, Graduate School of MedicineThe University of TokyoTokyoJapan
| | - Kentaro Usuda
- Department of Public Mental Health Research, National Institute of Mental HealthNational Center of Neurology and PsychiatryTokyoJapan
| | - Megumi Hazumi
- Department of Public Mental Health Research, National Institute of Mental HealthNational Center of Neurology and PsychiatryTokyoJapan
| | - Emi Okazaki
- Department of Public Mental Health Research, National Institute of Mental HealthNational Center of Neurology and PsychiatryTokyoJapan
| | | | - Mayumi Kataoka
- Department of Public Mental Health Research, National Institute of Mental HealthNational Center of Neurology and PsychiatryTokyoJapan
| | - Natsu Sasaki
- Department of Mental Health, Graduate School of MedicineThe University of TokyoTokyoJapan
| | - Yasutaka Ojio
- Department of Community Mental Health & Law, National Institute of Mental HealthNational Center of Neurology and PsychiatryTokyoJapan
| | - Asami Matsunaga
- Department of Community Mental Health & Law, National Institute of Mental HealthNational Center of Neurology and PsychiatryTokyoJapan
- Department of Mental Health and Psychiatric Nursing, Graduate School of Health Care SciencesTokyo Medical and Dental University (TMDU)Bunkyo‐kuJapan
| | - Ikue Umemoto
- National Center for Cognitive Behavior Therapy and ResearchNational Center of Neurology and PsychiatryTokyoJapan
| | - Miyuki Makino
- National Center for Cognitive Behavior Therapy and ResearchNational Center of Neurology and PsychiatryTokyoJapan
| | - Ayako Nakashita
- Department of Public Mental Health Research, National Institute of Mental HealthNational Center of Neurology and PsychiatryTokyoJapan
| | - Chiaki Kamikawa
- Department of Public Mental Health Research, National Institute of Mental HealthNational Center of Neurology and PsychiatryTokyoJapan
| | - Naoaki Kuroda
- Department of Community Mental Health & Law, National Institute of Mental HealthNational Center of Neurology and PsychiatryTokyoJapan
| | - Hironori Kuga
- National Center for Cognitive Behavior Therapy and ResearchNational Center of Neurology and PsychiatryTokyoJapan
| | | | - Daisuke Nishi
- Department of Public Mental Health Research, National Institute of Mental HealthNational Center of Neurology and PsychiatryTokyoJapan
- Department of Mental Health, Graduate School of MedicineThe University of TokyoTokyoJapan
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Ghahari D, Chaharlangi D, Bonato S, Sliekers S, Sockalingam S, Ali A, Benassi P. Educational Approaches Using Simulation for Psychiatric Risk Assessment: a Scoping Review. ACADEMIC PSYCHIATRY : THE JOURNAL OF THE AMERICAN ASSOCIATION OF DIRECTORS OF PSYCHIATRIC RESIDENCY TRAINING AND THE ASSOCIATION FOR ACADEMIC PSYCHIATRY 2024; 48:61-70. [PMID: 37584887 DOI: 10.1007/s40596-023-01836-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Accepted: 07/18/2023] [Indexed: 08/17/2023]
Abstract
OBJECTIVE The ability to assess a patient's risk of harm to self or others is a core competency for mental health clinicians which can have significant patient outcomes. With the growth of simulation in medical education, there is an opportunity to enhance education outcomes for psychiatric risk assessment. The purpose of this study was to determine how simulation is used to build competency in risk assessment and map its educational outcomes. METHODS The authors conducted a systematic scoping review using the Arksey and O'Malley framework. Electronic database searches were conducted by an academic librarian. Studies published before August 2022 which described simulation activities aimed at training clinicians in suicide, self-harm, and/or violence risk assessment were screened for eligibility. RESULTS Of the 21,814 articles identified, 58 studies were selected for inclusion. The majority described simulations teaching suicide risk assessment, and there was a notable gap for building competency in violence risk assessment. Simulation utility was demonstrated across emergency, inpatient, and outpatient settings involving adult and pediatric care. The most common simulation modality was patient actors. A smaller subset implemented technological approaches, such as automated virtual patient avatars. Outcomes included high learner satisfaction, and increases in psychiatric risk assessment knowledge, competency, and performance. CONCLUSION Simulation as an adjuvant to existing medical curricula can be used to teach risk assessment in mental health. Based on the results of our review, the authors provide recommendations for medical educators looking to design and implement simulation in mental health education.
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Affiliation(s)
| | | | - Sarah Bonato
- Centre for Addiction and Mental Health (CAMH), Toronto, ON, Canada
| | | | - Sanjeev Sockalingam
- University of Toronto, Toronto, ON, Canada
- Centre for Addiction and Mental Health (CAMH), Toronto, ON, Canada
| | - Amina Ali
- University of Toronto, Toronto, ON, Canada
- Centre for Addiction and Mental Health (CAMH), Toronto, ON, Canada
| | - Paul Benassi
- University of Toronto, Toronto, ON, Canada
- Centre for Addiction and Mental Health (CAMH), Toronto, ON, Canada
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Fujieda M, Uchida K, Ikebe S, Kimura A, Kimura M, Watanabe T, Sakamoto H, Matsumoto T, Uchimura N. Fatigue on Waking, Insomnia, and Workplace Relationship Problems May Help to Detect Suicidal Ideation among New Middle-Aged Primary Care Patients: A 6-Month Prospective Study in Japan. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20085547. [PMID: 37107831 PMCID: PMC10138726 DOI: 10.3390/ijerph20085547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 03/27/2023] [Accepted: 04/13/2023] [Indexed: 05/11/2023]
Abstract
Signs of suicidal depression often go undetected in primary care settings. This study explored predictive factors for depression with suicidal ideation (DSI) among middle-aged primary care patients at 6 months after an initial clinic visit. New patients aged 35-64 years were recruited from internal medicine clinics in Japan. Baseline characteristics were elicited using self-administered and physician questionnaires. DSI was evaluated using the Zung Self-Rating Depression Scale and the Profile of Mood States at enrollment and 6 months later. Multiple logistic regression analysis was conducted to calculate adjusted odds ratios for DSI. Sensitivity, specificity, and likelihood ratios for associated factors were calculated. Among 387 patients, 13 (3.4%) were assessed as having DSI at 6 months. Adjusted for sex, age, and related factors, significant odds ratios for DSI were observed for "fatigue on waking ≥1/month" (7.90, 95% confidence intervals: 1.06-58.7), "fatigue on waking ≥1/week" (6.79, 1.02-45.1), "poor sleep status" (8.19, 1.05-63.8), and "relationship problems in the workplace" (4.24, 1.00-17.9). Fatigue on waking, sleep status, and workplace relationship problems may help predict DSI in primary care. Because the sample size in this investigation was small, further studies with larger samples are needed to confirm our findings.
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Affiliation(s)
- Megumi Fujieda
- Department of Neuropsychiatry, Kurume University School of Medicine, 67 Asahi-machi, Kurume 830-0011, Fukuoka, Japan
- Department of Environmental Medicine, Kurume University School of Medicine, 67 Asahi-machi, Kurume 830-0011, Fukuoka, Japan
- Department of Healthcare Management, College of Healthcare Management, 960-4 Takayanagi, Setaka-machi, Miyama 835-0018, Fukuoka, Japan
- Correspondence: ; Tel.: +81-942-31-7564
| | - Katsuhisa Uchida
- Mental Health and Welfare Center of Shizuoka Prefectural Government, 2-20 Ariake-cho, Suruga-ku, Shizuoka-shi 422-8031, Shizuoka, Japan
| | - Shinichiro Ikebe
- Fuji Medical Association, 2850 Denbo, Fuji 417-0061, Shizuoka, Japan
| | - Akihiro Kimura
- Fuji Medical Association, 2850 Denbo, Fuji 417-0061, Shizuoka, Japan
| | - Masashi Kimura
- Fuji Medical Association, 2850 Denbo, Fuji 417-0061, Shizuoka, Japan
| | - Toshiaki Watanabe
- Fuji Medical Association, 2850 Denbo, Fuji 417-0061, Shizuoka, Japan
| | - Hisako Sakamoto
- Mental Health and Welfare Center of Shizuoka Prefectural Government, 2-20 Ariake-cho, Suruga-ku, Shizuoka-shi 422-8031, Shizuoka, Japan
| | - Teruaki Matsumoto
- Shizuoka General Hospital, 4-27-1 Kitaando, Aoi-ku, Shizuoka-shi 420-8527, Shizuoka, Japan
| | - Naohisa Uchimura
- Department of Neuropsychiatry, Kurume University School of Medicine, 67 Asahi-machi, Kurume 830-0011, Fukuoka, Japan
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Lund EM. Issues of Confidentiality and Potential Disability Discrimination in Behavior Intervention Team Responses to College Student Suicidality. JOURNAL OF DISABILITY POLICY STUDIES 2022. [DOI: 10.1177/10442073221094808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
In response to concerns about liability and safety, many colleges and universities have instituted Behavior Intervention Teams (BITs) to help assess and intervene with students who may pose a risk of harm to self or others. Students, lawyers, and advocates have raised concerns about some aspects of the implementation of BITs and related institutional policies, particularly with regard to students who are suicidal and those who engage in self-injurious behavior. Specifically, BITs are on complicated legal ground regarding confidentiality, disability civil rights law, and potential discriminatory or disparate treatment of students with psychiatric disabilities. In addition to reviewing the nature and background of BITs, this article reviews the professional, ethical, and legal issues surrounding confidentiality in the context of university intervention with students who are at risk for harm to self and the potentially applicable of disability civil rights law to BIT intervention with students who are suicidal. Suggestions for alternative and supplemental interventions, especially widespread use of suicide gatekeeping, are provided. Finally, the need for advocates who are knowledgeable in disability civil rights law is highlighted.
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Eldridge A, Chen J, Furnari M, Makowichuk K, Black WE. Adopting a Peer-to-Peer Approach to Trainee Suicide Prevention. ACADEMIC PSYCHIATRY : THE JOURNAL OF THE AMERICAN ASSOCIATION OF DIRECTORS OF PSYCHIATRIC RESIDENCY TRAINING AND THE ASSOCIATION FOR ACADEMIC PSYCHIATRY 2021; 45:306-307. [PMID: 32696427 DOI: 10.1007/s40596-020-01284-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Accepted: 07/01/2020] [Indexed: 06/11/2023]
Affiliation(s)
- Alyssa Eldridge
- Oregon Health & Science University (OHSU), Portland, OR, USA.
| | - Jason Chen
- Oregon Health & Science University (OHSU), Portland, OR, USA
- VA Portland Health Care System, Portland, OR, USA
| | - Megan Furnari
- Oregon Health & Science University (OHSU), Portland, OR, USA
| | - Kristy Makowichuk
- American Foundation for Suicide Prevention (AFSP), Oregon Chapter, Oregon City, OR, USA
| | - Whitney E Black
- Oregon Health & Science University (OHSU), Portland, OR, USA
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Saini VK, Gehlawat P, Gupta T. Evaluation of knowledge and competency among nurses after a brief suicide prevention educational program: A pilot study. J Family Med Prim Care 2020; 9:6018-6022. [PMID: 33681036 PMCID: PMC7928102 DOI: 10.4103/jfmpc.jfmpc_984_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 08/31/2020] [Accepted: 09/28/2020] [Indexed: 11/04/2022] Open
Abstract
Background Suicide is major public health issue worldwide. The educational interventions in enhancing the knowledge, modifying the attitudes, and raising the competence levels of healthcare professionals to prevent suicides have shown positive results. However, these education programs are under-evaluated, especially in India. Aim The aim was to evaluate the effect on suicide prevention and management-related knowledge among nursing staff, attitudes, and competence for suicidal patients and their family members. Methods A brief suicide educational intervention training program was prepared for the study participants. The outcomes of this study were evaluated through a single group pre-test-post-test questionnaire. Result The mean age of the participants was 28.74 ± 5.73 years. Participants reported significant improvement in their attitude and knowledge about suicide after attending the training program. Conclusion Empowering primary health care staff including nurses to identify, assess, manage, and refer the suicidal person should be considered as an important step in suicide prevention.
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Affiliation(s)
- Vijay K Saini
- Department of Psychiatry, All India Institute of Medical Sciences- Jodhpur, Rajasthan, India
| | - Pratibha Gehlawat
- Department of Psychiatry, All India Institute of Medical Sciences- Jodhpur, Rajasthan, India
| | - Tanu Gupta
- Department of Psychiatry, All India Institute of Medical Sciences- Jodhpur, Rajasthan, India
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Choi YJ. Bilingual gatekeepers' experiences of immigrant women's acculturative stress and mental health improvement in Korea: A qualitative analysis. SOCIAL BEHAVIOR AND PERSONALITY 2020. [DOI: 10.2224/sbp.9306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Immigrant women married to Korean men usually experience pressure to adapt to Korean family culture, which leads to increased vulnerability to mental health problems. I trained mental health gatekeepers who spoke both Korean and the women's original language to work with such women
from Thailand, Vietnam, China, Mongolia, Uzbekistan, and Japan. I explored the gatekeepers' experiences with their clients in focus group interviews, to identify comprehensive perspectives on the provision of services for community mental health practitioners. Data were analyzed using qualitative
content analysis, and I identified 17 codes, 8 interpretive codes, and 4 themes (gatekeepers building relationships from heart to heart, soothing hardship by speaking in the same mother tongue, encouraging mental health literacy, and instilling a sense of fulfillment), all of which motivated
the core theme of caring for acculturative stress with fulfillment and pride. As cultural affinity plays a key role, more bilingual gatekeepers should be trained and employed to improve community mental health literacy and the effectiveness of multicultural services.
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Piot MA, Dechartres A, Attoe C, Jollant F, Lemogne C, Layat Burn C, Rethans JJ, Michelet D, Cross S, Billon G, Guerrier G, Tesniere A, Falissard B. Simulation in psychiatry for medical doctors: A systematic review and meta-analysis. MEDICAL EDUCATION 2020; 54:696-708. [PMID: 32242966 DOI: 10.1111/medu.14166] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Revised: 03/14/2020] [Accepted: 03/23/2020] [Indexed: 05/06/2023]
Abstract
CONTEXT Most medical doctors are likely to work with patients experiencing mental health conditions. However, educational opportunities for medical doctors to achieve professional development in the field of psychiatry are often limited. Simulation training in psychiatry may be a useful tool to foster this development. OBJECTIVES The purpose of this study was to assess the effectiveness of simulation training in psychiatry for medical students, postgraduate trainees and medical doctors. METHODS For this systematic review and meta-analysis, we searched eight electronic databases and trial registries up to 31 August 2018. We manually searched key journals and the reference lists of selected studies. We included randomised and non-randomised controlled studies and single group pre- and post-test studies. Our main outcomes were based on Kirkpatrick levels. We included data only from randomised controlled trials (RCTs) using random-effects models. RESULTS From 46 571 studies identified, we selected 163 studies and combined 27 RCTs. Interventions included simulation by role-play (n = 69), simulated patients (n = 72), virtual reality (n = 22), manikin (n = 5) and voice simulation (n = 2). Meta-analysis found significant differences at immediate post-tests for simulation compared with active and inactive control groups for attitudes (standardised mean difference [SMD] = 0.52, 95% confidence interval [CI] 0.31-0.73 [I2 = 0.0%] and SMD = 0.28, 95% CI 0.04-0.53 [I2 = 52.0%], respectively), skills (SMD = 1.37, 95% CI 0.56-2.18 [I2 = 93.0%] and SMD = 1.49, 95% CI 0.39-2.58 [I2 = 93.0%], respectively), knowledge (SMD = 1.22, 95% CI 0.57-1.88 [I2 = 0.0%] and SMD = 0.72, 95% CI 0.14-1.30 [I2 = 80.0%], respectively), and behaviours (SMD = 1.07, 95% CI 0.49-1.65 [I2 = 68.0%] and SMD = 0.45, 95% CI 0.11-0.79 [I2 = 41.0%], respectively). Significant differences in terms of patient benefit and doctors' behaviours and skills were found at the 3-month follow-up. CONCLUSIONS Despite heterogeneity in methods and simulation interventions, our findings demonstrate the effectiveness of simulation training in psychiatry training.
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Affiliation(s)
- Marie-Aude Piot
- Epidemiological and Public Health Research Centre, Villejuif, France
- University of Paris, Faculty of Health, Medicine School, Paris, France
- Department of Psychiatry, Institute Mutualiste Montsouris, Paris, France
- Health Care Simulation Center iLumens, University of Paris, France
| | - Agnès Dechartres
- Sorbonne Université, Institut National de la Santé et de la Recherche Médicale (INSERM), Institut Pierre Louis d'Epidémiologie et de Santé Publique, AP-HP.Sorbonne Université, Hôpital Pitié Salpêtrière, Département de Santé Publique, Paris, France
| | - Chris Attoe
- Maudsley Simulation, South London and Maudsley NHS Foundation Trust, London, UK
| | - Fabrice Jollant
- University of Paris, Faculty of Health, Medicine School, Paris, France
- Department of Psychiatry, GHU Paris Psychiatry and Neurosciences, Sainte-Anne Hospital Center, Paris, France
- Department of Psychiatry, Nîmes Academic Hospital (CHU), Nîmes, France
- Department of Psychiatry, McGill University, Montréal, Québec, Canada
| | - Cédric Lemogne
- University of Paris, Faculty of Health, Medicine School, Paris, France
- University of Paris, INSERM, Institute of Psychiatry and Neurosciences of Paris (IPNP), Paris, France
- AP-HP.Centre-University of Paris, European Georges-Pompidou Hospital, Department of Psychiatry, Paris, France
| | - Carine Layat Burn
- Department of Orthopaedic Surgery, La Providence Hospital, Neuchâtel, Switzerland
- Department of Psychotherapy, Berger Psychotherapeutic Centre, Neuchâtel, Switzerland
| | - Jan-Joost Rethans
- Institute for Education and Skills Lab, Faculty of Health, Medicine and Life Sciences, Maastricht University, the Netherlands
| | - Daphne Michelet
- Health Care Simulation Center iLumens, University of Paris, France
- Department of Pediatric Anesthesia, CHU of Reims Hôpital Maison Blanche, Reims, France
| | - Sean Cross
- Maudsley Simulation, South London and Maudsley NHS Foundation Trust, London, UK
| | - Gregoire Billon
- Maudsley Simulation, South London and Maudsley NHS Foundation Trust, London, UK
| | - Gilles Guerrier
- University of Paris, Faculty of Health, Medicine School, Paris, France
- Health Care Simulation Center iLumens, University of Paris, France
- Department of Anaesthesiology, Cochin Hospital, AP-HP, Paris, France
| | - Antoine Tesniere
- University of Paris, Faculty of Health, Medicine School, Paris, France
- Health Care Simulation Center iLumens, University of Paris, France
| | - Bruno Falissard
- Epidemiological and Public Health Research Centre, Villejuif, France
- Department of Public health, School of Medecine, University Paris Saclay, Villejuif, France
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Orui M, Fukasawa M, Horikoshi N, Suzuki Y, Kawakami N. Development and Evaluation of a Gatekeeper Training Program Regarding Anxiety about Radiation Health Effects Following a Nuclear Power Plant Accident: A Single-Arm Intervention Pilot Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17124594. [PMID: 32604809 PMCID: PMC7344952 DOI: 10.3390/ijerph17124594] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 06/23/2020] [Accepted: 06/25/2020] [Indexed: 12/21/2022]
Abstract
After the Fukushima Daiichi Nuclear Power Plant accident in March 2011, residents perceived a radiation exposure risk. To address the concerns about radiation exposure and the subsequent effects on their health, we developed the gatekeeper training program for radiation health anxiety and mental health issues. The program consisted of a presentation and roleplay, with educational objectives to the increase knowledge and understanding around radiation health anxiety, alcoholism, depression, and suicide. Twenty-six counselors participated in the program as a single-arm intervention. To measure the outcomes, the subjects reported self-confidence when they counselled with residents with radiation health anxiety and other mental health issues. Comparing the answers to pre- and 2-month follow-up surveys, the confidence levels were higher after 2 months than at baseline, especially for the question "How confident are you at supporting a resident with mental health issues?", which showed the largest increase (p < 0.001). Regarding radiation health anxiety the questions "Can you communicate coping skills to a resident with radiation health anxiety?" (p = 0.007) and "Can you refer a resident with radiation health anxiety to professionals who can cope appropriately?" (p = 0.016) showed significant increases in their confidence levels. This program could be useful for on-going health activities and future nuclear disasters.
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Affiliation(s)
- Masatsugu Orui
- Department of Public Health, School of Medicine, Fukushima Medical University, Fukushima 960-1295, Japan; (N.H.); (Y.S.)
- Sendai City Mental Health and Welfare Center, Sendai 980-0845, Japan
- Correspondence: ; Tel.: +81-24-547-1180
| | - Maiko Fukasawa
- Department of Mental Health, Graduate School of Medicine, The University of Tokyo, Tokyo 113-0033, Japan; (M.F.); (N.K.)
| | - Naoko Horikoshi
- Department of Public Health, School of Medicine, Fukushima Medical University, Fukushima 960-1295, Japan; (N.H.); (Y.S.)
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima 960-1295, Japan
| | - Yuriko Suzuki
- Department of Public Health, School of Medicine, Fukushima Medical University, Fukushima 960-1295, Japan; (N.H.); (Y.S.)
- National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo 187-8553, Japan
| | - Norito Kawakami
- Department of Mental Health, Graduate School of Medicine, The University of Tokyo, Tokyo 113-0033, Japan; (M.F.); (N.K.)
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11
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Kashihara J, Sakamoto S. Exploring perceived costs and benefits of first aid for youth with depression: a qualitative study of Japanese undergraduates. Int J Ment Health Syst 2020; 14:34. [PMID: 32489419 PMCID: PMC7247138 DOI: 10.1186/s13033-020-00366-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Accepted: 05/16/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Early interventions for depression among youth are greatly needed. Although Youth Mental Health First Aid (YMHFA) program has been developed to teach the public how to help young people with mental disorders, including depression, it has assumed human altruism and overlooked the possibility that participants would experience conflict between the costs and benefits of helping behaviors. The present qualitative study, therefore, initially explored content of the costs and benefits perceived by youth in terms of helping their peers with depression. METHODS A total of 56 Japanese undergraduates (32 female, 24 male; M age = 20.20, SD = 1.09) participated in the face-to-face survey. They were provided with basic knowledge about helping behaviors and were presented with a vignette describing an undergraduate with depression. Then, they left free descriptive comments on their views of the costs/benefits of helping/not helping the person in the vignette. As supplemental quantitative analyses, we statistically compared numbers of labels (n = 624), which were obtained from participants' comments, across two (costs/benefits) × two (helping/not helping) domains. Finally, we conducted a qualitative content analysis that combined inductive and deductive methods to categorize these labels. RESULTS The supplemental quantitative analyses (i.e., ANOVA and post hoc analyses) on the numbers of labels highlighted that the participants perceived suppressors (i.e., costs of helping, benefits of not helping) as well as motivators (i.e., costs of not helping) in making decision to help peers with depression. The qualitative content analysis mainly showed that: (i) the categories in each domain covered multiple facets of costs and benefits, including negative/positive effects on the participants themselves, the person in the vignette, and interpersonal relationships; and that (ii) the participants perceived the conflicts of costs and benefits regardless of whether they help their peers with depression. CONCLUSIONS These results provide evidence for how young people experience the conflicts between the costs and benefits of helping behaviors toward their peers with depression and reveal specific content of these costs and benefits. These findings could serve as a basis for extending YMHFA programs and designing educational content to promote public helping behaviors in realistic situations.
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Affiliation(s)
- Jun Kashihara
- College of Humanities and Sciences, Nihon University, 3-25-40 Sakurajosui, Setagaya-ku, Tokyo, 156-8550 Japan
- Melbourne School of Population and Global Health, The University of Melbourne, 235 Bouverie St, Carlton, VIC 3053 Australia
- Japan Society for the Promotion of Science, Kojimachi Business Center Building, 5-3-1 Kojimachi, Chiyoda-ku, Tokyo, 102-0083 Japan
- Present Address: Faculty of Sociology, Toyo University, 5-28-20 Hakusan, Bunkyo-ku, Tokyo, 112-8606 Japan
| | - Shinji Sakamoto
- College of Humanities and Sciences, Nihon University, 3-25-40 Sakurajosui, Setagaya-ku, Tokyo, 156-8550 Japan
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12
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Kubo H, Urata H, Sakai M, Nonaka S, Saito K, Tateno M, Kobara K, Hashimoto N, Fujisawa D, Suzuki Y, Otsuka K, Kamimae H, Muto Y, Usami T, Honda Y, Kishimoto J, Kuroki T, Kanba S, Kato TA. Development of 5-day hikikomori intervention program for family members: A single-arm pilot trial. Heliyon 2020; 6:e03011. [PMID: 31938741 PMCID: PMC6953643 DOI: 10.1016/j.heliyon.2019.e03011] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Revised: 11/13/2019] [Accepted: 12/06/2019] [Indexed: 11/19/2022] Open
Abstract
Backgrounds Hikikomori, a severe form of social withdrawal, is increasingly a serious mental health issue worldwide. Hikikomori is comorbid with various psychiatric conditions including depression, social anxiety and suicidal behaviors. Family support is encouraged as a vital first step, however evidence-based programs have yet to be established. Mental Health First Aid (MHFA) is one of the most well-validated educational programs encouraging lay people such as family members, to support close persons suffering from various psychiatric conditions such as depression, anxiety and suicidal behaviors. Methods We newly developed an educational program for family members of hikikomori sufferers mainly based on MHFA and 'Community Reinforcement and Family Training (CRAFT)' with role-play and homework. As a single-arm trial, 21 parents (7 fathers and 14 mothers) living with hikikomori sufferers participated in our program with five once-a-week sessions (2 h per session) and six monthly follow-ups, and its effectiveness was evaluated using various self-rated questionnaires. Results Perceived skills toward a depressed hikikomori case vignette, stigma held by participants, and subscales of two problematic and one adaptive behaviors of hikikomori sufferers were improved throughout the sessions and follow-ups. In addition, positive behavioral changes of hikikomori sufferers such as improved social participation were reported by participants. Limitations Single-arm design and evaluation using self-rated questionnaires are the main limitations of the present study. Conclusions Our newly developed program has positive effects on family members in their contact and support of hikikomori sufferers. Future trials with control groups are required to validate the effectiveness of this program.
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Affiliation(s)
- Hiroaki Kubo
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Maidashi 3-1-1, Higashi-ku, Fukuoka, 812-8582, Japan
| | - Hiromi Urata
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Maidashi 3-1-1, Higashi-ku, Fukuoka, 812-8582, Japan
| | - Motohiro Sakai
- Faculty of Education, University of Miyazaki, 1-1 Gakuen Kibanadai-nishi, Miyazaki, Miyazaki, 889-2192, Japan
| | - Shunsuke Nonaka
- School of Child Psychology, Tokyo Future University, 34-12 Senju Akebono-cho, Adachi-ku, Tokyo, 120-0023, Japan
| | - Kazuhiko Saito
- Aiiku Counseling Office, Aiiku Research Institute, Imperial Gift Foundation Boshi-Aiiku-Kai, 5-6-8 Minami-azabu, Minato-ku, Tokyo, 106-8580, Japan
| | - Masaru Tateno
- Department of Neuropsychiatry, Sapporo Medical University, S1 W17, Chuo-ku, Sapporo, 060-8556, Japan
| | - Keiji Kobara
- Shimane Prefectural Counseling Center for Physical and Mental Health, 1741-3 Higashi-Tsuda-Cho, Matsue, Shimane, 690-0011, Japan
| | - Naoki Hashimoto
- Department of Psychiatry, Hokkaido University Graduate School of Medicine, Kita 15, Nishi 7, Kita-ku, Sapporo, 060-8638, Japan
| | - Daisuke Fujisawa
- Department of Neuropsychiatry, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Yuriko Suzuki
- Department of Mental Health Policy, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-Higashi, Kodaira, Tokyo, 187-8553, Japan
| | - Kotaro Otsuka
- Department of Neuropsychiatry, School of Medicine, Iwate Medical University, 19-1 Uchimaru, Morioka, Iwate, 020-8505, Japan
| | - Hiroho Kamimae
- Fukuoka City Mental Health and Welfare Center, Maizuru 2-5-1, Chuo-ku, Fukuoka, 810-0073, Japan
| | - Yuya Muto
- Fukuoka City Mental Health and Welfare Center, Maizuru 2-5-1, Chuo-ku, Fukuoka, 810-0073, Japan
| | - Takashi Usami
- Fukuoka City Mental Health and Welfare Center, Maizuru 2-5-1, Chuo-ku, Fukuoka, 810-0073, Japan
| | - Yoko Honda
- Fukuoka City Mental Health and Welfare Center, Maizuru 2-5-1, Chuo-ku, Fukuoka, 810-0073, Japan
| | - Junji Kishimoto
- Center for Clinical and Translational Research, Kyushu University, Maidashi 3-1-1, Higashi-ku, Fukuoka, 812-8582, Japan
| | - Toshihide Kuroki
- Department of Clinical Psychology Practice, Graduate School of Human-Environment Studies, Kyushu University, 744 Motooka, Nishi-ku, Fukuoka, 819-0395, Japan
| | - Shigenobu Kanba
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Maidashi 3-1-1, Higashi-ku, Fukuoka, 812-8582, Japan
| | - Takahiro A. Kato
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Maidashi 3-1-1, Higashi-ku, Fukuoka, 812-8582, Japan
- Corresponding author.
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Boukouvalas E, El-Den S, Murphy AL, Salvador-Carulla L, O'Reilly CL. Exploring Health Care Professionals' Knowledge of, Attitudes Towards, and Confidence in Caring for People at Risk of Suicide: a Systematic Review. Arch Suicide Res 2020; 24:S1-S31. [PMID: 30856366 DOI: 10.1080/13811118.2019.1586608] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Health care professionals are paramount to the prevention and management of suicidal thoughts and behaviors. Confidence in caring for people at risk of suicidal thoughts and behaviors is influenced by knowledge of and attitudes towards suicide. This systematic review aimed to explore health care professionals' knowledge of and attitudes towards suicide, as well as, their confidence in caring for people at risk of suicidal thoughts and behaviors. A systematic search of 4 electronic databases over 10 years was conducted. Following retrieval of 1,723 abstracts, 46 primary research publications were included, involving both cross-sectional (n = 27) and intervention study designs (n = 19). Knowledge of, attitudes towards, and confidence in caring for people at risk of suicidal thoughts and behaviors were explored among primary health care professionals, specialists, and health care students. The influence of training and education, type of health care professional, country of practice, and prior experience with suicide were highlighted among included studies. Health care professionals' knowledge of, attitudes towards and confidence in caring for people at risk of suicide are complex, interrelated constructs that shape their behaviors and may impact patient outcomes. Suicide training and education is necessary within health care curricula and as part of health care professionals' continuing professional development.
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14
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Kubo H, Urata H, Katsuki R, Hirashima M, Ueno S, Suzuki Y, Fujisawa D, Hashimoto N, Kobara K, Cho T, Mitsui T, Kanba S, Otsuka K, Kato TA. Development of MHFA-based 2-h educational program for early intervention in depression among office workers: A single-arm pilot trial. PLoS One 2018; 13:e0208114. [PMID: 30532174 PMCID: PMC6285460 DOI: 10.1371/journal.pone.0208114] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2018] [Accepted: 11/07/2018] [Indexed: 11/18/2022] Open
Abstract
Objective In the workplace depression and suicide are serious mental health problems. A lack of knowledge and mental health skills along with the stigma toward mental health problems often results in delays in seeking professional help. Interventions targeting not only persons with mental health problems but also people around the individual are warranted in order to encourage supporting behavior within entire workplace. In the present study, we investigated the efficacy of our newly developed educational training program in the management with depression and suicidal risk in the workplace as a single-arm pilot trial. Methods The program is a two-hour (2-h) training course for employees based on the Mental Health First Aid (MHFA) program which aims to increase public mental health literacy. We conducted this program at a company workplace among 91 employees, and ultimately 83 participants completed the self-rated questionnaires. Changes in confidence and practical skills in early intervention of depression and suicide-prevention, and stigma toward mental health problems were evaluated using self-rated questionnaires at 3 time-points; pre-program, immediately post-program, and 1 month after the program. Results Confidence and practical skills were significantly improved even 1 month after the program, and stigma reduced just after the program. Conclusions Our pilot study suggests that the program has a positive impact on encouraging employees to support their co-workers with mental health problems, and is applicable for busy workers due to its short duration. A single-arm design, evaluation using self-rated questionnaire and short-term follow up period are the main limitations of the present study. Hence, future research is required to validate the effects of this program with control groups, and also to assess long-term effectiveness and objective changes such as absenteeism and sick leave. Trial registration UMIN Clinical Trials Registry (UMIN-CTR) R000023258
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Affiliation(s)
- Hiroaki Kubo
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Fukuoka, Japan
| | - Hiromi Urata
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Fukuoka, Japan
| | - Ryoko Katsuki
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Fukuoka, Japan
| | | | | | - Yuriko Suzuki
- Department of Mental Health Policy, National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan
| | - Daisuke Fujisawa
- Department of Neuropsychiatry, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan
| | - Naoki Hashimoto
- Department of Psychiatry, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan
| | - Keiji Kobara
- Shimane Prefectural Counseling Center for Physical and Mental Health, Matsue, Shimane, Japan
| | - Tetsuji Cho
- Mie Prefectural Mental Medical Center, Tsu, Mie, Japan
| | - Toshiko Mitsui
- Kitakyushu Mental Health Center, Kitakyushu, Fukuoka, Japan
| | - Shigenobu Kanba
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Fukuoka, Japan
| | - Kotaro Otsuka
- Department of Neuropsychiatry, School of Medicine, Iwate Medical University, Morioka, Iwate, Japan
| | - Takahiro A. Kato
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Fukuoka, Japan
- * E-mail:
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15
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Jorm AF, Ross AM. Guidelines for the public on how to provide mental health first aid: narrative review. BJPsych Open 2018; 4:427-440. [PMID: 30450221 PMCID: PMC6235998 DOI: 10.1192/bjo.2018.58] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Revised: 07/18/2018] [Accepted: 09/12/2018] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Expert-consensus guidelines have been developed for how members of the public should assist a person with a mental health problem or in a mental health crisis. AIMS This review aimed to examine the range of guidelines that have been developed and how these have been implemented in practice. METHOD A narrative review was carried out based on a systematic search for literature on the development or implementation of the guidelines. RESULTS The Delphi method has been used to develop a wide range of guidelines for English-speaking countries, Asian countries and a number of other cultural groups. The primary implementation has been through informing the content of training courses. CONCLUSION Further work is needed on guidelines for low- and middle-income countries. DECLARATION OF INTEREST A.F.J. is an unpaid member of the Board of Mental Health First Aid International (trading as Mental Health First Aid Australia), which is a not-for-profit organisation.
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Affiliation(s)
- Anthony F Jorm
- Professorial Fellow, Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Australia
| | - Anna M Ross
- Research Assistant, Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Australia
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16
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Confidence and attitudes of pharmacy students towards suicidal crises: patient simulation using people with a lived experience. Soc Psychiatry Psychiatr Epidemiol 2018; 53:1185-1195. [PMID: 30155558 DOI: 10.1007/s00127-018-1582-2] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Accepted: 08/20/2018] [Indexed: 01/30/2023]
Abstract
PURPOSE Health care professionals, including pharmacists, have the potential to recognise and assist those at risk of suicide. The primary aim of this study was to assess the impact of utilising people with a lived experience of mental illness as simulated patients on final year pharmacy students' attitudes toward and confidence in caring for people at risk of suicide after first receiving Mental Health First Aid (MHFA) training. METHODS A parallel group repeated measures design was used. People with a lived experience of mental illness enacted patients experiencing a mental health crisis, including possible suicidal ideation. Following MHFA training, the first group directly participated in the simulation, the second group observed, and the final group had no exposure to the simulation. Validated surveys measuring student attitudes and confidence were conducted at three time points; pre and post MHFA, and then at 2-4 weeks follow-up. RESULTS Full datasets of survey responses were received from 34/40 direct participants (85%), 104/146 observers (71%) and 50/66 comparison students (76%). Mean confidence scores significantly improved for all groups post MHFA training (p < 0.05). At follow-up, all 8 confidence items for the direct participant and observer group maintained significance from baseline to post intervention (p < 0.05). Mixed results in relation to attitudes towards suicide were evident at each time point and among each participant group. CONCLUSIONS Utilising people with a lived experience of mental illness as simulated patients has a positive effect on sustaining pharmacy student confidence in discussing suicidal behaviour post MHFA training. The inconsistency in attitudes towards suicide suggests that attitudes are complex in nature, involving multiple dynamic influences.
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17
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Osafo J, Akotia CS, Boakye KE, Dickson E. Between moral infraction and existential crisis: Exploring physicians and nurses' attitudes to suicide and the suicidal patient in Ghana. Int J Nurs Stud 2018; 85:118-125. [DOI: 10.1016/j.ijnurstu.2018.05.017] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2017] [Revised: 05/23/2018] [Accepted: 05/25/2018] [Indexed: 11/24/2022]
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18
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Weerasinghe M, Konradsen F, Eddleston M, Pearson M, Jayamanne S, Gunnell D, Hawton K, Agampodi S. Vendor-based restrictions on pesticide sales to prevent pesticide self-poisoning - a pilot study. BMC Public Health 2018; 18:272. [PMID: 29463230 PMCID: PMC5819692 DOI: 10.1186/s12889-018-5178-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2017] [Accepted: 02/16/2018] [Indexed: 11/30/2022] Open
Abstract
Background In South Asia, up to 20% of people ingesting pesticides for self-poisoning purchase the pesticide from a shop with the sole intention of self-harm. Individuals who are intoxicated with alcohol and/or non-farmers represent 72% of such high-risk individuals. We aimed to test the feasibility and acceptability of vendor-based restrictions on pesticide sales for such high-risk individuals. Methods We conducted a pilot study in 14 (rural = 7, urban = 7) pesticide shops in Anuradhapura District of Sri Lanka. A two-hour training program was delivered to 28 pesticide vendors; the aim of the training was to help vendors recognize and respond to customers at high risk of pesticide self-poisoning. Knowledge and attitudes of vendors towards preventing access to pesticides for self-poisoning at baseline and in a three month follow-up was evaluated by questionnaire. Vendors were interviewed to explore the practice skills taught in the training and their assessment of the program. Results The scores of knowledge and attitudes of the vendors significantly increased by 23% (95% CI 15%–32%, p < 0.001) and by 16% (95% CI 9%–23%, p < 0.001) respectively in the follow-up. Fifteen (60%) vendors reported refusing sell pesticides to a high-risk person (non-farmer or intoxicated person) in the follow-up compared to three (12%) at baseline. Vendors reported that they were aware from community feedback that they had prevented at least seven suicide attempts. On four identified occasions, vendors in urban shops had been unable to recognize the self-harming intention of customers who then ingested the pesticide. Only 2 (8%) vendors were dissatisfied with the training and 23 (92%) said they would recommend it to other vendors. Conclusions Our study suggests that vendor-based sales restriction in regions with high rates of self-poisoning has the potential to reduce access to pesticides for self-poisoning. A large-scale study of the effectiveness and sustainability of this approach is needed. Electronic supplementary material The online version of this article (10.1186/s12889-018-5178-2) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Manjula Weerasinghe
- Department of Community Medicine, Faculty of Medicine & Allied Sciences, Rajarata University of Sri Lanka, Anuradhapura, Sri Lanka. .,South Asian Clinical Toxicology Research Collaboration, Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka. .,Centre for Pesticide Suicide Prevention, and Pharmacology, Toxicology and Therapeutics, Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK.
| | - Flemming Konradsen
- South Asian Clinical Toxicology Research Collaboration, Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka.,Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Michael Eddleston
- South Asian Clinical Toxicology Research Collaboration, Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka.,Centre for Pesticide Suicide Prevention, and Pharmacology, Toxicology and Therapeutics, Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK.,Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Melissa Pearson
- South Asian Clinical Toxicology Research Collaboration, Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka.,Centre for Pesticide Suicide Prevention, and Pharmacology, Toxicology and Therapeutics, Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK
| | - Shaluka Jayamanne
- South Asian Clinical Toxicology Research Collaboration, Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka.,Department of Medicine, Faculty of Medicine, University of Kelaniya, Ragama, Sri Lanka
| | - David Gunnell
- Population Health Sciences, University of Bristol, Bristol, UK
| | - Keith Hawton
- Centre for Suicide Research, Department of Psychiatry, University of Oxford, Oxford, UK
| | - Suneth Agampodi
- Department of Community Medicine, Faculty of Medicine & Allied Sciences, Rajarata University of Sri Lanka, Anuradhapura, Sri Lanka
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Painter NA, Kuo GM, Collins SP, Palomino YL, Lee KC. Pharmacist training in suicide prevention. J Am Pharm Assoc (2003) 2018; 58:199-204.e2. [PMID: 29366695 DOI: 10.1016/j.japh.2017.12.007] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2017] [Revised: 11/20/2017] [Accepted: 12/11/2017] [Indexed: 10/18/2022]
Abstract
OBJECTIVE Suicide in the United States is a major preventable public health problem. Pharmacists need to be educated on suicide prevention strategies so that they can increase their own awareness and identify patients at-risk. A training program for pharmacists was used to provide skills necessary to recognize a crisis and the warning signs of suicide. The program's effect on the participant's general perception, self-efficacy, and attitude towards suicide prevention was examined. SETTING Various academic, health care, and professional meetings throughout San Diego County. PRACTICE INNOVATION First Question, Persuade, and Refer training program targeting pharmacists. EVALUATION A self-administered presurvey, postsurvey and, Program Outcome Evaluation were given to participants of the suicide training program. Items included demographics, general perception, self-efficacy, and attitude toward suicide prevention. Descriptive statistics were used to describe participants' demographics. t tests were used to compare general perception, attitudes, and self-efficacy scores between pretest and post-program evaluation survey responses. Nonparametric Wilcoxon signed rank analyses for matched pairs were used to compare survey responses that asked about attitudes before and after trainings. Regression analyses were conducted to assess factors associated with general perception, self-efficacy, and attitudes. RESULTS Participants were more likely to update knowledge after training and reported more confidence to make an intervention for a patient at risk for suicide. CONCLUSION Our findings suggest that a suicide prevention training program helped pharmacist respondents build confidence in several self-efficacy areas relating to detection of suicide signs, response to patients with suicidal thoughts, reassurance for patients, and provision of resources and referrals.
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20
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Lygnugaryte-Griksiene A, Leskauskas D. Assessing suicide management skills of emergency medical services providers before and after suicide intervention/prevention training with Lithuanian version of suicide intervention response inventory. Neuropsychiatr Dis Treat 2018; 14:3405-3412. [PMID: 30587992 PMCID: PMC6298398 DOI: 10.2147/ndt.s186253] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Effective suicide management skills of emergency medical services (EMS) providers are crucially important in Lithuania, which has the highest suicide rates in Europe. METHODS Respondents were 268 EMS providers, doctors (n=78) and nurses (n=190), who agreed to participate in suicide prevention/intervention training and completed the survey twice. Study was conducted in five steps: adaptation of Lithuanian version of Suicide Intervention Response Inventory (SIRI-LT); initial assessment of suicide counseling skills of the EMS providers using SIRI-LT; suicide prevention/intervention training; second assessment of suicide counseling skills using SIRI-LT 6 months after training; data analysis evaluating the skills and effectiveness of the training among different groups of EMS providers (doctors vs nurses, age groups). RESULTS SIRI-LT showed good internal consistency: Cronbach's alpha score of 0.85 (pretest) and 0.73 (posttest). The value of Kaiser-Meyer-Olkin measure of sampling adequacy was 0.849. A four-factor solution was forced and accounted for 40.8% of the variance. The SIRI-LT mean total scores before suicide prevention/intervention training were significantly higher for doctors than for nurses (13.01±5.24 vs 11.36±5.14, respectively; P=0.031). Younger respondents with a shorter period of employment and heavier workload were significantly more effective at suicide management than older respondents with a longer period of employment and lower workload. After suicide prevention/intervention training, SIRI-LT mean total scores decreased for doctors (13.0±5.24 vs 11.02±4.76; P=0.031) and significantly increased in older (≥55 age) respondents (11.85±3.82 vs 9.28±4.44; P=0.022). CONCLUSION SIRI-LT has good internal consistency and can be considered a good instrument for assessing suicide management skills of EMS providers. Our results suggest that ability to find appropriate responses to suicide situations may be multidimensional, related to cultural setting and influenced by age, education, motivation, engagement, and emotional distraction. Particular attention should be paid to active listening and empathic communication skills when developing suicide prevention/intervention training for EMS providers.
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Affiliation(s)
| | - Darius Leskauskas
- Department of Psychiatry at Lithuanian University of Health Sciences, Kaunas, Lithuania,
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21
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Nakagami Y, Kubo H, Katsuki R, Sakai T, Sugihara G, Naito C, Oda H, Hayakawa K, Suzuki Y, Fujisawa D, Hashimoto N, Kobara K, Cho T, Kuga H, Takao K, Kawahara Y, Matsumura Y, Murai T, Akashi K, Kanba S, Otsuka K, Kato TA. Development of a 2-h suicide prevention program for medical staff including nurses and medical residents: A two-center pilot trial. J Affect Disord 2018; 225:569-576. [PMID: 28886497 DOI: 10.1016/j.jad.2017.08.074] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2017] [Revised: 07/26/2017] [Accepted: 08/27/2017] [Indexed: 12/16/2022]
Abstract
BACKGROUND Suicide is a crucial global health concern and effective suicide prevention has long been warranted. Mental illness, especially depression is the highest risk factor of suicide. Suicidal risk is increased in people not only with mental illness but also with physical illnesses, thus medical staff caring for physically-ill patients are also required to manage people with suicidal risk. In the present study, we evaluated our newly developed suicide intervention program among medical staff. METHODS We developed a 2-h suicide intervention program for medical staff, based on the Mental Health First Aid (MHFA), which had originally been developed for the general population. We conducted this program for 74 medical staff members from 2 hospitals. Changes in knowledge, perceived skills, and confidence in early intervention of depression and suicide-prevention were evaluated using self-reported questionnaires at 3 points; pre-program, immediately after the program, and 1 month after program. RESULTS This suicide prevention program had significant effects on improving perceived skills and confidence especially among nurses and medical residents. These significant effects lasted even 1 month after the program. LIMITATIONS Design was a single-arm study with relatively small sample size and short-term follow up. CONCLUSIONS The present study suggests that the major target of this effective program is nurses and medical residents. Future research is required to validate the effects of the program with control groups, and also to assess long-term effectiveness and actual reduction in suicide rates.
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Affiliation(s)
- Yukako Nakagami
- Department of Psychiatry, Kyoto University Graduate School of Medicine, Shogoin-Kawaharacho 54, Kyoto 606-8507, Japan
| | - Hiroaki Kubo
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Maidashi 3-1-1, Higashi-ku, Fukuoka 812-8582, Japan
| | - Ryoko Katsuki
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Maidashi 3-1-1, Higashi-ku, Fukuoka 812-8582, Japan
| | - Tomomichi Sakai
- Aso Iizuka Hispital, Iizuka, 3-83 Yoshio, machi, Iizuka, Fukuoka 820-0018, Japan
| | - Genichi Sugihara
- Department of Psychiatry, Kyoto University Graduate School of Medicine, Shogoin-Kawaharacho 54, Kyoto 606-8507, Japan
| | - Chisako Naito
- Integrated Clinical Education Center, Patient Safety Unit, Kyoto University Hospital, Shogoin-Kawaharacho 54, Kyoto 606-8507, Japan
| | - Hiroyuki Oda
- Aso Iizuka Hispital, Iizuka, 3-83 Yoshio, machi, Iizuka, Fukuoka 820-0018, Japan
| | - Kohei Hayakawa
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Maidashi 3-1-1, Higashi-ku, Fukuoka 812-8582, Japan
| | - Yuriko Suzuki
- Department of Adult Mental Health, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-Higashi, Kodaira, Tokyo 187-8553, Japan
| | - Daisuke Fujisawa
- Department of Neuropsychiatry, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
| | - Naoki Hashimoto
- Department of Psychiatry, Hokkaido University Graduate School of Medicine, North 15, West 7, Sapporo 060-8638, Japan
| | - Keiji Kobara
- Shimane Prefectural Counseling Center for Physical and Mental Health, 1741-3 Higashi-Tsuda-Cho, Matsue, Shimane 690-0011, Japan
| | - Tetsuji Cho
- Mie Prefectural Mental Medical Center, 1-12-1 Shiroyama, Tsu, Mie 514-0818, Japan
| | - Hironori Kuga
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Maidashi 3-1-1, Higashi-ku, Fukuoka 812-8582, Japan; Division of Clinical Research, National Hospital Organization, Hizen Psychiatric Center, 160 Mitsu, Yoshinogari-cho, Kanzaki-gun, Saga 842-0192, Japan
| | - Kiyoshi Takao
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Maidashi 3-1-1, Higashi-ku, Fukuoka 812-8582, Japan; Division of Clinical Research, National Hospital Organization, Hizen Psychiatric Center, 160 Mitsu, Yoshinogari-cho, Kanzaki-gun, Saga 842-0192, Japan
| | - Yoko Kawahara
- Department of Neuropsychiatry, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
| | - Yumi Matsumura
- Patient Safety Unit, Kyoto University Hospital, Shogoin-Kawaharacho 54, Kyoto 606-8507, Japan
| | - Toshiya Murai
- Department of Psychiatry, Kyoto University Graduate School of Medicine, Shogoin-Kawaharacho 54, Kyoto 606-8507, Japan
| | - Koichi Akashi
- Clinical Education Center, Kyushu University Hospital, Kyushu University, Maidashi 3-1-1, Higashi-ku, Fukuoka 812-8582, Japan; Department of Medicine and Biosystemic Science, Graduate School of Medical Sciences, Kyushu University, Maidashi 3-1-1, Higashi-ku, Fukuoka 812-8582, Japan
| | - Shigenobu Kanba
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Maidashi 3-1-1, Higashi-ku, Fukuoka 812-8582, Japan
| | - Kotaro Otsuka
- Department of Neuropsychiatry, School of Medicine, Iwate Medical University, 19-1 Uchimaru, Morioka, Iwate 020-8505, Japan
| | - Takahiro A Kato
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Maidashi 3-1-1, Higashi-ku, Fukuoka 812-8582, Japan.
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Kopp-Bigault C, Audouard-Marzin Y, Scouarnec P, Beauchamp G, Séguin M, Walter M. [French translation and validation of a short version of the Suicide Intervention Response Inventory-2 (SIRI-2-VF)]. Encephale 2017; 44:435-445. [PMID: 29096910 DOI: 10.1016/j.encep.2017.07.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2016] [Revised: 07/25/2017] [Accepted: 07/25/2017] [Indexed: 10/18/2022]
Abstract
OBJECTIVES Training health professionals about suicidal crisis is one major line of suicide prevention worldwide. France has one of the highest suicide rates in Europe, and although crisis intervention training has been set up since 2001, there presently is no training assessment tool in the French language for health professionals trained in suicide prevention. In the four levels of Kirpatrick's education pyramid, training that takes place in France today solely assesses level one status, that is to say relative to the level of satisfaction of participants (self-report). This study proposes a validated short French version of the Suicide Intervention Response Inventory-2 (SIRI-2) of Neimeyer & Mc Innes. The SIRI-2 questionnaire assesses the ability of first line intervention in dealing with suicidal individuals. METHODS The translation methodology was inspired from Vallerand's model of cross-cultural back translation. This method is regularly used for translating from the English language to a French version. In order to translate the English version, we used an extensive 7-step methodology implicating several bilingual translators, expert reviewers (psychologists and psychiatrists) and a scientific committee. Participants were 107 students from different French universities and study programs: psychology, medicine and nursing (17 were men; average age was 26.6). Fifteen of these participants answered the SIRI-2-VF on two occasions (separated by a 15-day interval) in order to estimate the temporal stability of the instrument. The scores of the students were compared to six French experts in suicide prevention and with the original expert group who worked on the development of SIRI-2 (n=7). We used Student t Test for construct validity, Cronbach's Alpha for internal consistency and Pearson's correlation coefficient for temporal stability. RESULTS Following a fidelity comparison of the results of the French experts with those of the American experts, ten items presenting the least good fidelity were suppressed in order to obtain a short version of the SIRI-2 containing 15 questions (SIRI-2-VF). Statistical analyses of the short version (15 questions, SIRI-2-VF) showed good validity (difference between experts and subjects is significant: t=31.5, P<0.001) and reliability (good internal consistency: α=0.850 for positive statements and α=0.830 for negative statements, and a temporal stability: r=0.827, bilateral test, P<0.001). CONCLUSIONS This tool should improve the range of specific instruments in French suicidology adapted for French culture of suicide intervention. It is the first tool in France that reaches level 2a of Kirkpatrick's pyramid to assess clinical skills after training in suicidology.
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Affiliation(s)
- C Kopp-Bigault
- University of Strasbourg (EA3071), 67000 Strasbourg, France; Morlaix Hospital, 29600 Brittany, France.
| | - Y Audouard-Marzin
- Collège des hautes études en médecine (CHEM), 29200 Brest, France; CRPV, centre hospitalier universitaire régional de Brest, 29200 Brest, France
| | - P Scouarnec
- Morlaix Hospital, 29600 Brittany, France; Collège des hautes études en médecine (CHEM), 29200 Brest, France; CRPV, centre hospitalier universitaire régional de Brest, 29200 Brest, France
| | - G Beauchamp
- Department of psychoeducation and psychology, université du Québec, Outaouais, Canada
| | - M Séguin
- Department of psychoeducation and psychology, université du Québec, Outaouais, Canada; McGill Group on Suicide Studies, Montréal, Québec, Canada; Québec Network on Suicide Research, Québec, Canada; Centre intégré de santé et service social de l'Outaouais (CISSSO), Outaouais, Canada
| | - M Walter
- Psychiatry Unit, Brest University and Research Hospital, 29200 Brest, France
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Lygnugaryte-Griksiene A, Leskauskas D, Jasinskas N, Masiukiene A. Factors influencing the suicide intervention skills of emergency medical services providers. MEDICAL EDUCATION ONLINE 2017; 22:1291869. [PMID: 28235388 PMCID: PMC5345589 DOI: 10.1080/10872981.2017.1291869] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
BACKGROUND Lithuania currently has the highest suicide rate in Europe and the fifth highest worldwide. AIMS To identify the factors that influence the suicide intervention skills of emergency medical services (EMS) providers (doctors, nurses, paramedics). METHOD Two hundred and sixty-eight EMS providers participated in the research. The EMS providers were surveyed both prior to their training in suicide intervention and six months later. The questionnaire used for the survey assessed their socio-demographic characteristics, suicide intervention skills, attitudes towards suicide prevention, general mental health, strategies for coping with stress, and likelihood of burnout. RESULTS Better suicide intervention skills were more prevalent among EMS providers with a higher level of education, heavier workload, more positive attitudes towards suicide prevention, better methods of coping with stress, and those of a younger age. Six months after the non-continuous training in suicide intervention, the providers' ability to assess suicide risk factors had improved, although there was no change in their suicide intervention skills. CONCLUSIONS In order to improve the suicide intervention skills of EMS providers, particular attention should be paid to attitudes towards suicide prevention, skills for coping with stress, and continuous training in suicide intervention. ABBREVIATIONS EMS: Emergency medical services; SIRI: Suicide intervention response inventory.
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Affiliation(s)
- Aidana Lygnugaryte-Griksiene
- Psychiatric Department of Hospital of Lithuanian University of Health Sciences Kaunas Clinics, Kaunas, Lithuania
- CONTACT Aidana Lygnugaryte-Griksiene Psychiatry Department, Lithuanian University of Health Sciences Hospital, Kaunas Clinics, Eiveniu str. 2, KaunasLT-50161, Lithuania
| | - Darius Leskauskas
- Psychiatric Department of Hospital of Lithuanian University of Health Sciences Kaunas Clinics, Kaunas, Lithuania
| | - Nedas Jasinskas
- Emergency Medical Department of Hospital of Lithuanian University of Health Sciences Kaunas Clinics, Kaunas, Lithuania
| | - Agne Masiukiene
- Kaunas St. Kazimieras Lower Secondary School, Kaunas, Lithuania
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Hashimoto N, Suzuki Y, Kato TA, Fujisawa D, Sato R, Aoyama-Uehara K, Fukasawa M, Asakura S, Kusumi I, Otsuka K. Effectiveness of suicide prevention gatekeeper-training for university administrative staff in Japan. Psychiatry Clin Neurosci 2016; 70:62-70. [PMID: 26303330 DOI: 10.1111/pcn.12358] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2015] [Revised: 07/27/2015] [Accepted: 08/19/2015] [Indexed: 11/26/2022]
Abstract
AIMS Suicide is a leading cause of death among Japanese college and university students. Gatekeeper-training programs have been shown to improve detection and referral of individuals who are at risk of suicide by training non-mental-health professional persons. However, no studies have investigated the effectiveness of such programs in university settings in Japan. The aim of this study was to investigate the effectiveness of the gatekeeper-training program for administrative staff in Japanese universities. METHODS We developed a 2.5-h gatekeeper-training program based on the Mental Health First Aid program, which was originally developed for the general public. Seventy-six administrative staff at Hokkaido University participated in the program. Competence and confidence in managing suicide intervention, behavioral intention as a gatekeeper and attitude while handling suicidal students were measured by a self-reported questionnaire before, immediately after and a month after the program. RESULTS We found a significant improvement in competence in the management of suicidal students. We also found improvements in confidence in management of suicidal students and behavioral intention as a gatekeeper after training, though questionnaires for those secondary outcomes were not validated. These improvements continued for a month. About 95% of the participants rated the program as useful or very useful and one-third of the participants had one or more chances to utilize their skills within a month. CONCLUSIONS The current results suggest the positive effects of the training program in university settings in Japan. Future evaluation that includes comparison with standard didactic trainings and an assessment of long-term effectiveness are warranted.
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Affiliation(s)
- Naoki Hashimoto
- Department of Psychiatry, Graduate School of Medicine, Hokkaido University, Sapporo, Japan.,Health Care Center, Hokkaido University, Sapporo, Japan.,Child and Adolescent Psychiatry, Department of Psychiatry, University of California San Francisco, San Francisco, USA
| | - Yuriko Suzuki
- Department of Adult Mental Health, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Takahiro A Kato
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Daisuke Fujisawa
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Ryoko Sato
- Department of Psychiatry, Yokohama City University School of Medicine, Yokohama, Japan
| | - Kumi Aoyama-Uehara
- Department of Psychiatry, Yokohama City University School of Medicine, Yokohama, Japan
| | - Maiko Fukasawa
- Department of Adult Mental Health, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Satoshi Asakura
- Department of Psychiatry, Graduate School of Medicine, Hokkaido University, Sapporo, Japan.,Health Care Center, Hokkaido University, Sapporo, Japan
| | - Ichiro Kusumi
- Department of Psychiatry, Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Kotaro Otsuka
- Department of Neuropsychiatry, Disaster and Community Psychiatry, Iwate Medical University, Iwate, Japan
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Heyman I, Webster BJ, Tee S. Curriculum development through understanding the student nurse experience of suicide intervention education--A phenomenographic study. Nurse Educ Pract 2015; 15:498-506. [PMID: 26025505 DOI: 10.1016/j.nepr.2015.04.008] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2014] [Revised: 02/11/2015] [Accepted: 04/30/2015] [Indexed: 11/27/2022]
Abstract
Suicide remains a global public health issue and a major governmental concern. The World Health Organisation argues for continued investment in education for front-line professionals, with a particular focus on nurses, to address the rising suicide levels. Considering this rate, it could be argued that suicide has impacted on the lives of many, including the student nurse population. Understanding the psychological impact, and influence on learning, whilst developing suicide intervention knowledge is crucial. However, little is known of the student experience in this complex and challenging area of skills development. This phenomenographic study examines the experiences of second year Bachelor of Nursing (mental health) students who participated in the Applied Suicide Intervention Skills Training (ASIST). Experiences were illuminated through two focus groups, Experiences were distilled and categorised through hierarchically relationships to construct a group experiential field to illustrate understandings of the impact this approach has on learning Students found ASIST to be emotionally challenging yet an extremely positive experience through bonding, peer learning, and class cohesion. The supportive workshop facilitation was essential allowing for full immersion into role simulation thus developing student confidence. Appropriate pedagogy and student support must be considered whilst developing suicide intervention in the pre-registration curricula.
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Affiliation(s)
- Inga Heyman
- School of Nursing and Midwifery, Faculty of Health and Social Care, Robert Gordon University, Garthdee Road, Aberdeen, Scotland Ab10 7QG, UK.
| | - Brian J Webster
- Faculty of Health, Life & Social Sciences, Edinburgh Napier University, Sighthill Campus, Sighthill Court, Edinburgh, Scotland EH11 4BN, UK.
| | - Stephen Tee
- Florence Nightingale School of Nursing and Midwifery King's College London, 57 Waterloo Road, London SE1 8WA, UK.
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Byrne K, McGowan I, Cousins W. Delivering Mental Health First Aid: an exploration of instructors' views. INTERNATIONAL JOURNAL OF MENTAL HEALTH PROMOTION 2015. [DOI: 10.1080/14623730.2014.995422] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Yamaguchi T, Fujii C, Nemoto T, Tsujino N, Takeshi K, Mizuno M. Differences between subjective experiences and observed behaviors in near-fatal suicide attempters with untreated schizophrenia: a qualitative pilot study. Ann Gen Psychiatry 2015; 14:17. [PMID: 25904969 PMCID: PMC4405822 DOI: 10.1186/s12991-015-0055-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2014] [Accepted: 03/31/2015] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND In cases of untreated schizophrenia, the patients' entourage often does not recognize the psychotic symptoms of the patient and the possibility that the patient may attempt suicide. The aim of this study was to investigate the discrepancies between the subjective experiences and observed behaviors in near-fatal suicide attempters with untreated schizophrenia. METHODS A semi-structured interview was carried out with seven near-fatal suicide attempters with untreated schizophrenia to examine the subjective experiences at the time of the suicide attempt. The families of the patients were also interviewed to determine their recognition of the patients' psychotic symptoms and the suicidal ideation. The interview data were analyzed qualitatively. RESULTS Six subjects were undergoing exacerbation of the psychotic symptoms at the time of exhibiting the suicide-related ideation. One subject had been in a prolonged depressive state before attempting suicide. Although all the patients experienced severe distress due to psychotic symptoms and depressive mood, they all exhibited only low level or no help-seeking behavior, and six of seven families had not recognized the change in the patient's mental condition. CONCLUSIONS Appropriate information about schizophrenia should be provided to the general public so that any help-seeking by the patients with this disease is not overlooked. In addition, accessible early intervention services for psychosis should be established.
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Affiliation(s)
- Taiju Yamaguchi
- Department of Neuropsychiatry, School of Medicine, Toho University, 6-11-1 Omori-nishi, Ota-ku, Tokyo 143-8541 Japan
| | - Chiyo Fujii
- Department of Forensic Psychiatry, National Center of Neurology and Psychiatry, National Institute of Mental Health, 4-1-1 Ogawa-Higashi, Kodaira, Tokyo 1878553 Japan
| | - Takahiro Nemoto
- Department of Neuropsychiatry, School of Medicine, Toho University, 6-11-1 Omori-nishi, Ota-ku, Tokyo 143-8541 Japan
| | - Naohisa Tsujino
- Department of Neuropsychiatry, School of Medicine, Toho University, 6-11-1 Omori-nishi, Ota-ku, Tokyo 143-8541 Japan
| | - Kiyoaki Takeshi
- Department of Neuropsychiatry, School of Medicine, Toho University, 6-11-1 Omori-nishi, Ota-ku, Tokyo 143-8541 Japan
| | - Masafumi Mizuno
- Department of Neuropsychiatry, School of Medicine, Toho University, 6-11-1 Omori-nishi, Ota-ku, Tokyo 143-8541 Japan
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Effectiveness of brief suicide management training programme for medical residents in Japan: a cluster randomized controlled trial. Epidemiol Psychiatr Sci 2014; 23:167-76. [PMID: 23867112 PMCID: PMC6998177 DOI: 10.1017/s2045796013000334] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Aims. To evaluate the effectiveness of a brief suicide management training programme for Japanese medical residents compared with the usual lecture on suicidality. Methods. In this multi-center, clustered randomized controlled trial, the intervention group attended a structured suicide management programme and the control group, the usual lecture on depression and suicidality. The primary outcome was the difference in residents' cumulative competency score to manage suicidal persons from baseline (T0) to 1 month after the intervention (T2), determined using the Suicide Intervention Response Inventory (SIRI-1) score, at individual level. Results. Analysis of 114 residents (intervention group n = 65, control group n = 49) assigned to two clusters in each group revealed no change in SIRI-1 score from T0 to T2 or immediately after the intervention (T1) between the two groups. As a secondary analysis, discrepancy in judgement between the participants and Japanese suicidologists was examined immediately after the intervention in the adjusted model, with a mean difference in score of 9.98 (95% confidence interval: 4.39-15.56; p = 0.001). Conclusions. The structured programme was not proven to improve competency in suicide management when measured by the SIRI-1 score. Further elaboration of the programme and valid measurement of its outcome would be needed to show the program's effectiveness.
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Fujisawa D, Suzuki Y, Kato TA, Hashimoto N, Sato R, Aoyama-Uehara K, Fukasawa M, Tomita M, Watanabe K, Kashima H, Otsuka K. Suicide intervention skills among Japanese medical residents. ACADEMIC PSYCHIATRY : THE JOURNAL OF THE AMERICAN ASSOCIATION OF DIRECTORS OF PSYCHIATRIC RESIDENCY TRAINING AND THE ASSOCIATION FOR ACADEMIC PSYCHIATRY 2013; 37:402-407. [PMID: 23703377 DOI: 10.1007/bf03340078] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
OBJECTIVES Patient suicide is a tragic occurrence, and it can be a demoralizing experience for medical residents. Few studies, however, have assessed suicide management skills among these front-line healthcare professionals. This study evaluated the self-assessed competence and confidence of medical residents with regard to the management of potentially suicidal patients and assessed the correlation with the residents' background characteristics. METHOD The authors conducted a multicenter, cross-sectional survey of 114 medical residents in Japan, using a modified version of the Suicide Intervention Response Inventory (SIRI-2), the Medical Outcomes Study 8-Item Short-Form Health Survey (SF-8), and a 5-point Likert scale to assess confidence in suicide management. RESULTS A majority (89.5%) of the residents rated their confidence in managing suicidal patients as Not At All Confident or Rather Not Confident, although most were close to completing their psychiatric rotation. Results on the SIRI-2 suggested intermediate competence in managing suicidal behavior, as compared with that of other healthcare professionals. Competence as indicated by the SIRI-2 score was weakly and negatively correlated with the score for self-perceived Vitality on the SF-8 scale. CONCLUSION Insufficient skills and lack of confidence in the management of suicidal patients was observed in this sample of Japanese medical residents, thus highlighting the need for improved suicide-management programs for junior medical residents in Japanese hospitals.
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Kato TA, Balhara YPS, Chawla JM, Tateno M, Kanba S. Undergraduate medical students' attitudes towards psychiatry: an international cross-sectional survey between India and Japan. Int Rev Psychiatry 2013; 25:378-84. [PMID: 24032491 DOI: 10.3109/09540261.2013.812959] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Undergraduate psychiatric education has an important role in developing psychiatric knowledge, decreasing stigma towards mental illness, and promoting psychiatry as a career choice. The attitudes and beliefs of medical students towards psychiatry have not been well understood, especially in non-western countries. To clarify this aspect, we have conducted a cross-sectional study between India and Japan. This study, conducted at two centres, one each in India and Japan, used a semi-structured questionnaire to evaluate the attitudes and beliefs of third-year medical students towards mental illness and psychiatry; such as emotions experienced dealing with psychiatric patients, aetiology and treatment of psychiatric disorders, and psychiatry as a career choice. A total of 79 medical students from India and 77 from Japan participated in the present study. Significant differences were observed in the emotions experienced by the medical students while dealing with psychiatric patients. Most medical students (> 90%) from both study sites favoured psychiatrists for treatment of psychiatric illness. Psychiatry as a carrier choice was significantly related to the nationality of the medical students. The findings of the current study provide insight in to the attitudes of third-year medical students from India and Japan towards psychiatric patients.
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Affiliation(s)
- Takahiro A Kato
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University , Fukuoka , Japan
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Kaniwa I, Kawanishi C, Suda A, Hirayasu Y. Effects of educating local government officers and healthcare and welfare professionals in suicide prevention. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2012; 9:712-21. [PMID: 22690158 PMCID: PMC3367272 DOI: 10.3390/ijerph9030712] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/16/2012] [Revised: 02/02/2012] [Accepted: 02/21/2012] [Indexed: 11/22/2022]
Abstract
Suicide is a major public health issue. In Japan, local governments are responsible for suicide prevention, and local government officers are therefore expected to act as gatekeepers for suicide prevention. In this study, through a questionnaire survey, the authors examined the current knowledge and attitudes concerning suicide prevention among local government officers and healthcare and welfare professionals, and the effects of providing suicide prevention education on their knowledge of and attitudes toward suicide and its prevention. One hundred eighty-three local government officers and 432 healthcare/welfare professionals completed the survey before and after a single education session. Before the session, the local government officers and healthcare/welfare professionals showed mainly positive attitudes toward suicide prevention efforts, with little difference between the two groups. After the training, knowledge and attitudes were further improved for most questionnaire items. Respondents with one or more experiences of suicide prevention training showed significantly more knowledge and positive attitudes before the training than those with no such experience. Moreover, knowledge of depression and having a sympathetic attitude were found to be especially associated with the overall attitude that “suicide can be prevented”. Training in suicide prevention was shown to be effective in promoting appropriate knowledge and attitudes among local government officers and healthcare/welfare professionals who are gatekeepers for preventing suicide. Our findings confirm the importance of suicide prevention education, and will contribute to creating a standard educational program on suicide prevention in Japan.
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Affiliation(s)
- Isao Kaniwa
- Department of Psychiatry, Yokohama City University School of Medicine, 3-9 Fukuura, Yokohama 236-0004, Japan.
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Colucci E, Kelly CM, Minas H, Jorm AF, Suzuki Y. Mental Health First Aid guidelines for helping a suicidal person: a Delphi consensus study in Japan. Int J Ment Health Syst 2011; 5:12. [PMID: 21592409 PMCID: PMC3108941 DOI: 10.1186/1752-4458-5-12] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2011] [Accepted: 05/19/2011] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND This study aimed to develop guidelines for how a member of the Japanese public should provide mental health first aid to a person who is suicidal. METHODS The guidelines were produced by developing a questionnaire containing possible first aid actions and asking an expert panel of 32 Japanese mental health professionals to rate whether each action should be included in the guidelines. The content of the questionnaire was based on a systematic search of the relevant evidence and claims made by authors of consumer and carer guides and websites. The panel members were asked to complete the questionnaire by web survey. Three rounds of the rating were carried and, at the end of each round, items that reached the consensus criterion were selected for inclusion in the guidelines. During the first round, panel members were also asked to suggest any additional actions that were not covered in the original questionnaire (to include items that are relevant to local cultural circumstances, values, and social norms). Responses to these open-ended questions were used to generate new items. RESULTS The output from the Delphi process was a set of agreed upon action statements. The Delphi process started with 138 statements, 38 new items were written based on suggestions from panel members and, of these 176 items, 56 met the consensus criterion. These statements were used to develop the guidelines appended to this article. CONCLUSIONS There are a number of actions that are considered to be useful for members of the Japanese public when they encounter someone who is experiencing suicidal thoughts or engaging in suicidal behaviour. Although the guidelines are designed for members of the public, they may also be helpful to health professionals working in health and welfare settings who do not have clinical mental health training.
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Affiliation(s)
- Erminia Colucci
- Centre for International Mental Health, Melbourne School of Population Health, The University of Melbourne, Parkville, Victoria 3010, Australia
| | - Claire M Kelly
- Mental Health First Aid Training and Research Program, Orygen Youth Health Research Centre, Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria 3052, Australia
| | - Harry Minas
- Centre for International Mental Health, Melbourne School of Population Health, The University of Melbourne, Parkville, Victoria 3010, Australia
| | - Anthony F Jorm
- Mental Health First Aid Training and Research Program, Orygen Youth Health Research Centre, Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria 3052, Australia
| | - Yuriko Suzuki
- Department of Adult Mental Health, National Institute of Mental Health, NCNP, Kodaira, Tokyo, Japan
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Kato TA, Tateno M, Umene-Nakano W, Balhara YPS, Teo AR, Fujisawa D, Sasaki R, Ishida T, Kanba S. Impact of biopsychosocial factors on psychiatric training in Japan and overseas: are psychiatrists oriented to mind, brain, or sociocultural issues? Psychiatry Clin Neurosci 2010; 64:520-30. [PMID: 20923431 PMCID: PMC4932895 DOI: 10.1111/j.1440-1819.2010.02133.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
AIM To clarify the impact of biopsychosocial factors on psychiatric training under the new and traditional postgraduate medical education system in Japan and to compare them with young psychiatrists from other countries. METHODS Psychiatric residents and early-career psychiatrists were recruited in Japan and other countries. Using mail-based and web-based self-administered questionnaires, we evaluated participants' demographic information, motivation to become psychiatrists, interest and commitment to various aspects of psychiatry, and reactions to a case vignette, focusing on biopsychosocial factors. RESULTS A total of 137 responses, 81 from Japan and 56 from other countries, were collected. Before starting psychiatric training, Japanese participants showed a strong interest in 'mind' and less interest in 'brain' and 'environmental factors', while the interest in 'brain' and 'environmental factors' is presently as high as that in 'mind.' Japanese participants reported less commitment to their training toward ICD/DSM-based diagnosis, interview, pharmacotherapy, psychosocial treatment and epidemiology, compared with participants from other countries. In particular, Japanese participants showed less commitment to their training in suicide prevention, despite their perception of its high importance due to a high suicide rate in Japan. Suicide risk of a case vignette proved to be differently assessed according to participants' commitment levels to each aspect of psychiatry. CONCLUSION Our results suggest that young psychiatrists' attitudes concerning the biopsychosocial model generally become well-balanced with psychiatric training, however sociocultural factors do not seem to be well represented in the Japanese psychiatric training system. Additional training on sociocultural issues, such as suicide in Japan, should be considered.
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Affiliation(s)
- Takahiro A Kato
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
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